Document Detail


Temozolomide induced liver injury.
MedLine Citation:
PMID:  22141295     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
A 62-year female received radiotherapy over six weeks with daily 75 mg/m2 Temozolomide (TMZ) for Glioblastoma (GB). At the last week of radiotherapy, her liver enzymes and serum bilirubin started deteriorating. TMZ was discontinued. The histopathology demonstrated the features of acute cholestasis and focal parenchymal inflammation. A range of investigations failed to show any other contributory cause of hepatitis. She required in-hospital care for a prolonged period for a grade three hepatic failure. The liver functions very slowly recovered over 40 weeks, but her general condition continues to deteriorate. TMZ may cause a mild temporary rise in the liver enzymes and has been reported to reactivate hepatitis B. In few other cases concomitant medications were the possible causes of hepatitis. However, searching the Medline and other bibliographic database, we have not come across any case of TMZ-induced liver injury (TMZ-DILI). Histopathology and pattern of liver enzyme elevation suggest that unlike Dacarbazine, which causes veno-occlusive type liver damage, TMZ in this patient caused mainly cholestasis type liver injury. On Naranjo Adverse Drug Reaction (ADR) probability scale, this case falls in probable grade (Scale 7).
Authors:
Sanjay Dixit; Mohan Hingorani; Ponnambath Afzal; A P Campbell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurologica Belgica     Volume:  111     ISSN:  0300-9009     ISO Abbreviation:  Acta Neurol Belg     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-12-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0247035     Medline TA:  Acta Neurol Belg     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  249-51     Citation Subset:  IM    
Affiliation:
Castle Hill Hospital, Hull, UK. sanjay.dixit@hey.nhs.uk
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